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    Epidemiology of hepatitis B, hepatitis C, and syphilis co-infections in HIV-1 patients: a retrospective cross-sectional study of prevalence and viral load correlates
    (K Faisal Spec Hosp Res Centre, 2025) Aydogan, Sibel; Kirca, Fusun; Gozalan, Aysegul; Aslan, Ferhat Gurkan; Gurler, Merve; Toyran, Alparslan; Dinc, Bedia
    BACKGROUND: Co-infections with hepatitis B (HBV), hepatitis C (HCV) and syphilis complicate the clinical management of people living with HIV by influencing disease progression, treatment response, and transmission risk. Despite the growing HIV burden in T & uuml;rkiye, data on the impact of these coinfections remain limited. OBJECTIVES: To determine the prevalence of HBV, HCV, and syphilis coinfections in adults with HIV-1 and to examine their associations with demographics and HIV-1 viral load. DESIGN: Retrospective cross-sectional study SETTING: Single center, tertiary care hospital in T & uuml;rkiye PATIENTS AND METHODS: Adults diagnosed with HIV-1 between March 2019 and June 2024 at Ankara Bilkent City Hospital were included. Demographic information, HIV viral load measurements, and serological and molecular test results for HBV, HCV, and syphilis were retrieved from the institutional laboratory database. Coinfection status was assessed relative to age, gender, and HIV viral load. MAIN OUTCOME MEASURES: Prevalence and distribution of HBV, HCV, and syphilis coinfections and their associations with demographic variables and HIV viral load. SAMPLE SIZE: 724 patients RESULTS: The study population was predominantly male (86%), with a median age of 40 years. Syphilis was the most common coinfection (25.6%), followed by HBV at 4.1% and HCV at 1.8%. Syphilis was significantly more prevalent among men (P=.001), and HBV coinfection was associated with older age (P=.005). No significant associations were observed between HIV viral load and any co-infection. Notably, a substantial proportion of patients, especially those newly diagnosed after 2019, had high HIV RNA levels, suggesting delayed diagnosis and treatment initiation. Triple coinfections were rare but remain clinically relevant. CONCLUSIONS: The high prevalence of syphilis and delayed HIV diagnoses highlight the urgent need for improved screening protocols, timely initiation of antiretroviral therapy, and broader implementation of HBV vaccination programs. An integrated multisectoral approach is critical to address the overlapping clinical and public health burdens posed by these co-infections. Healthcare strategies must consider the impact of COVID-19-related service disruptions, which likely contributed to delays in diagnosis and treatment. LIMITATIONS: Lack of data on patients' behavioral risk factors and no follow-up on treatment outcomes for syphilis
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    Impact of non-pharmaceutical interventions on circulating respiratory viruses during the COVID-19 pandemic in Turkey
    (K Faisal Spec Hosp Res Centre, 2023) Kirca, Fusun; Aydogan, Sibel; Gozalan, Aysegul; Guler, Ezgi; Erten, Aysegul Zehra Uyan; Uygur, Ayse Sena Ozsen; Dogan, Alper
    BACKGROUND: Non-pharmaceutical interventions (NPIs) applied to limit the SARS-CoV-2 pandemic also affect the circulation and seasonal characteristics of other respiratory viruses.OBJECTIVES: Assess the impact of NPIs on the spread and seasonal characteristics of non-SARS-CoV-2 respiratory viruses and examine viral respiratory co-infections.DESIGN: Retrospective cohortSETTING: Single center in Turkey.PATIENTS AND METHODS: Syndromic multiplex viral polymerase chain reaction (mPCR) panel results of patients admitted to the Ankara Bilkent City Hospital with symptoms of acute respiratory tract infec-tion between April 1, 2020 and October 30, 2022 were evaluated. Two study periods before and after 1 July 2021, when the restrictions were discontinued, were statistically analyzed and compared to determine the effect of NPIs on circulating respiratory viruses.MAIN OUTCOME MEASURES: Prevalence of respiratory viruses as determined by syndromic mPCR panel.SAMPLE SIZE: 11 300 patient samples were evaluated.RESULTS: At least one respiratory tract virus was detected in 6250 (55.3%) patients. Of these, at least one respiratory virus was detected in 5% in the first period (between April 1, 2020 and June 30, 2021, when NPIs were applied), and in 95% in the second period (between July 1, 2021 and October 30, 2022, when NPIs were relaxed). After the removal of NPIs, there was a statistically significant increase in hRV/EV, RSV-A/B, Flu A/H3, hBoV, hMPV, PIV-1, PIV-4, hCoV-OC43, PIV-2 and hCoV-NL63 (P<.05). In the 2020-2021 season, when strict NPIs were applied, all respiratory viruses evaluated did not have the usual sea-sonal peak and there were no seasonal influenza epidemics during this period.CONCLUSIONS: NPIs resulted in a dramatic decrease in the preva-lence of respiratory viruses and notable disruption of seasonal charac-teristics.LIMITATIONS: Single-center study and retrospective.CONFLICT OF INTEREST: None.
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    Molecular Characterization of Carbapenem-Resistant Acinetobacter baumannii Blood Culture Isolates from Three Hospitals in Turkey
    (Natl Inst Infectious Diseases, 2021) Gozalan, Aysegul; Unaldi, Ozlem; Guldemir, Dilek; Aydogan, Sibel; Kuzucu, Cigdem; Cakirlar, Fatma Koksal; Acikgoz, Ziya Cibali
    We aimed to investigate the clonal relationships, common sequence types, and carbapenemase genes in 177 non-repetitive blood culture isolates of Acinetobacter baumannii collected from patients at three university hospitals in Turkey in 2016. Molecular epidemiological characteristics of the isolates were examined using pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST) (Pasteur scheme-cpn60, fusA, gltA, pyrG, recA, rplB, and rpoB). Multiplex PCR was used to investigate the carbapenemase genes, including bla(OXA-23-like),bla(OXA-24-like), bla(OXA-48-like), bla(OXA-58-like), bla(IMP), bla(VIM) and bla(NDm). PFGE genotyping yielded 92 pulsotypes with a clustering ratio of 69.7%. As per a >= 85% similarity coefficient, 159 (90.9%) isolates were found to be clonally related. The bla(OXA-)(23-like) and bla(OXA-)(58)-like genes were identified in 100% and 28.2% of the isolates, respectively. The bla(NDM) gene was identified in two isolates. The MLST analysis included 54 isolates with different pulsotypes, and 29 sequence types (STs). Most of the isolates (n = 36) belonged to the clonal complex (CC)2, one isolate belonged to CC1, and one isolate belonged to CC164. Sixteen new STs (ST1235-ST1250) were identified. Identifying both global ST2 and a large number of new STs, revealed high genetic diversity in A. baumannii isolates in the study population.
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    Viral Respiratory Tract Infection Agents Detected Between Years 2019-2021, COVID-19, and Co-Infections
    (Ankara Microbiology Soc, 2023) Aydogan, Sibel; Kirca, Fusun; Gozalan, Ayeguel; Toyran, Alparslan; Basyigit, Tugcan; Omay, Ipek; Dinc, Bedia
    Respiratory tract infections are a major cause of morbidity and mortality at all ages and are seen as a very important public health problem all over the world. In this study, we aimed to evaluate the effect of the pandemic on the epidemiological and seasonal characteristics of the agents by analyzing the respiratory viral infection agents, viral co-infections and associations with Coronavirus diseases-2019 (COVID-19) studied by multiplex polymerase chain reaction (PCR) test in the molecular microbiology laboratory in a three-year period, including the one-year period before the pandemic. Between March 2019 and December 2021, 8825 respiratory tract specimens accepted to the molecular microbiology laboratory with respiratory tract multiplex PCR test requests were included in the study. In addition, severe acute respiratory syndrome (SARS-CoV-2) PCR test results of the patients with positive results with respiratory tract multiplex PCR test, which were studied within +/- 3 days, were evaluated retrospectively. Respiratory viral pathogens were detected using FTD Respiratory Pathogens 21 kit (Fast Tract Diagnos- tics, Siemens Healthineers Company). Two different kits based on real-time reverse transcription PCR were used for SARS-CoV-2 RNA detection in different periods. According to our results, at least one viral agent was detected in 2156 (24.4%) of a total of 8825 samples and a single agent was detected in 1843 (85.5%) of these. The distribution of viruses in the samples with a single agent was determined as RV, RSV A/B, HCoVs, AdV, flu A virus, MPV A/B, PIV 1-4, flu B virus, EV, BoV and PeV, in order of frequency. Multiple agents were found in 313 (14.5%) of these 2156 samples. They were found to be two agents in 291 samples, three in 21 samples and four in one sample. When the SARS-CoV-2 PCR test results of the patients who had positive results with respiratory tract multiplex PCR and who were studied within +/- 3 days were evaluated retrospectively, SARS-CoV-2 RNA was detected in 45 (3.5%) of 1277 samples in which at least one agent was detected. In four of these patients, SARS-CoV-2 was found together with multiple agents. Consequently, there was a sharp decrease in the prevalence of all viral agents during the pandemic period. It was evaluated that besides the COVID-19 infection, the restrictions applied during the pandemic period were also effective in this situation.